Processing the Last Few Weeks

Wow, what a month!  Due to an unprecedented number of viruses "going around" and the fact that so many people were out and about during the holiday season, our family got crushed with illness this last month.  I was sick with a cold/allergies, Husband had a cold and both boys had two bouts of stomach illness.  There were a lot of families that were going through the same thing that we were.  Practically everyone that I've spoken with in recent weeks has had a horror story of sick kids, sick kids at relatives houses for the holidays, sick kids on airplanes, sick kids missing breakfast with Santa...you get the idea. 

Our sick kids story was a little bit different than many other stories, though.  This is because we have a child with MCADD.  Food intake is so critical with MCADD kids, especially when they are already vulnerable because they are so young (LB was 9 months old during this spell of illness).  When they stop eating because of a tummy ache or when they lose nutrients in large quantities through diarrhea or vomiting, it is a medical emergency.  We have some methods that we can take at home to help him along, namely feeding him a glucose solution called polycose and a medicine called carnitine, but when that isn't enough, we head for the hospital so that he can have IV support to help him safely weather the illness and prevent metabolic crisis.

If LB was unaffected by MCADD, like our older son, he would have had a spot on the couch next to his big brother these last few weeks.  They would both have been drinking pedialyte, eating toast, vomiting in a bucket and waiting for the illness to run its course.  That method is just a little too risky for LB, though.  His body doesn't work the same way that his older brother's body does.  Pedialyte isn't enough to keep him hydrated and nourished during illness.  It doesn't have the sugar he needs.  It doesn't have the carnitine he needs.  His body would become hypoglycemic, his blood would become acidic and he would become very, very ill if he just sat on the couch with his big brother drinking pedialyte.  We know this thanks to the newborn screening that identified his MCADD.  His doctors know this thanks to the newborn screening that identified his MCADD.  No one takes any risks with his health. 

Every doctor we work with has said that it is safer for him to go to the hospital for IV support when he is sick than to risk him suffering a metabolic crisis which can have serious mental and physical side-effects, some of which could be irreversible.  So, when LB is sick, we call the metabolic clinic, we heed the advice of our specialists and we head for the hospital.  We stay in the hospital for a day or two until LB is eating well and no longer suffering from the vomiting and/or diarrhea that robs his body of essential nutrients.  Then, we come home.  LB goes on with his busy life of playing with toys, following his big brother around and making everyone smile.  We are so grateful that we know how to keep him safe in this manner.

Sometimes people tell me that they can't imagine how difficult it is to have to go to the hospital everytime your kid is sick.  While it is true that we have to juggle a lot of things (childcare, work, pets, household chores, meals, etc.) when we are in the hospital with LB, it is difficult to juggle all of those same things when any child is sick.  Sick kids are tough no matter if they are sitting on your couch vomiting in a bucket or sitting in a hospital room with an IV.  Sick kids are tough no matter if they have MCADD or are unaffected.  I'm slowly learning that the divide and conquer strategy of me in the hospital with LB and Husband at home with our older son is just going to be the new normal for us whenever we get this kind of illness in our family. 

In closing, we are thankful for:

1. LB, our sweet, happy baby
2. the newborn screening that identified LB's MCADD
3. the doctors and specialists who have taught us how to keep him safe
4. the hospital staff who have cared for LB during illness
5. the strong network of friends and neighbors who have supported us during his recent illnesses

 

TIP - Packing Your Hospital Bag

I have learned a thing or two about what to bring with me when we are sent to the ER, which has ultimately turned into a hospital admission 3 out of 3 times for us.  Obviously, if it is a dire emergency, don't spend time meticulously packing a bag -- just get yourself to the hospital!!  However, if you have time to throw a few things in a bag or have a friend meet you at the hospital with a bag, here are some tips on what to bring based on our experience:

REMEMBER TO BRING:

• A Couple Changes of Clothing for Your Baby:  Hanging out for a few hours or a few days in clothes that are soiled by the various bodily fluids that spew from a sick child can be pretty gross.
• A Couple Different Styles of Clothing for Your Baby: Depending on where they put the IV, it may be better to have short sleeves or long sleeves, short pants or long pants, onesies or t-shirts.  I've also found that it is not desirable to have the baby dressed in footie pants/jammies since they often need access to toes for pulse oximetry meters.  Best to have feet baby's free and bring warm socks.
• Bibs:  You can usually always get a box of Cheerios or a container of applesauce along with spoons, napkins, etc.  You aren't usually offered a bib.  Seeing as how your access to clothing is at a premium, it's best to protect the clothes you brought from meal messes.  I have managed to fashion a bib out of a hand towel that was in our room, but bibs are easier.  Throw one or two in your bag.
• A Change of Clothes for Yourself:  Let's face it, the vomit is always going to land on you, the diapers are always going to explode on you and the sticky food-stained fingers are always going to be pulling at your shirtsleeve.  You will feel grimy enough after a day or two without a shower.  At least you can have some clean clothes on hand.
• A Toiletry Bag for Yourself:  Pack a toothbrush, toothpaste, contact lens accoutrements, glasses, hand lotion, whatever you need to stay comfortable and at least mildly presentable for a couple days.  I'd also recommend packing some Tylenol/Advil or whatever your preferred over-the-counter pain reliever is.  There are lots of uncomfortable chairs and lots of stress to deal with and headaches can come with the territory.
• Cell Phone & Charger:  The battery will run low with all the updates flying around between family and friends on your little one's condition.  Be sure to bring a charger so that you aren't disconnected from your support system because your phone is dead.
• Easy to Clean Toys, Books and Distractions for Baby:  Even though he was sick, he was still a busy baby the whole time we were hospitalized.  Having a stash of distractions can be critical to keeping your kid from pulling out an IV for lack of anything else to play with.  I brought only toys and board books that were easy to clean/sanitize later so that I didn't worry about bringing any hospital germs home with us.  If your child has comfort objects like pacifiers or soothers, bring those along, too.  For older kids, all of the hospital rooms that we've been in (and even some of the ER cubicles) have had TVs and DVD players, so toss in a favorite movie, too.
• Distractions for You:  I spent a lot of time quietly holding LB while he napped and, since I'm not much of a TV person, I was glad that I brought along my eReader (and charger!) so that I could read, do email, browse the web, etc. during quiet times.
• Medications for You and Your Baby:  Some hospitals don't have specialized MCADD things like polycose and carnitine on hand readily.  If your kid takes it regularly or is being supplemented by it due to illness, bring it along.  Same goes for your medications.  If you have allergies and you spend two days without your allergy meds, you're going to start getting pretty miserable during a time that you need to be at your best.

Things you probably don't have to bring (or bring in large supply):

• Formula:  Once you're admitted to a room, formula is usually the first thing they bring to you.  They have most of the popular brands (Enfamil, Similac, Gerber) and most variations (regular, soy, gentle, etc.). Bring enough for the ER, but after that, you'll be covered.
• Diapers/Wipes:  Ditto here.  Once you're admitted to a room, the nurses will bring you whatever size diapers you need along with wipes.  Bring enough for the ER, but the pediatric floors of the hospital will have you covered.
• Food/Snacks:  The ER can bring your baby Cheerios/Crackers/etc.  Once admitted to the floor, unless your child has diet restrictions, you can usually order anything you want off the food service menu for him/her.  For kiddos not on finger-foods yet, pediatric floors have jars of baby food at the ready, too.  In terms of food for yourself, parents can usually order guest trays (at a cost) from the food service menu during their posted hours.  There are also vending machines and sometimes even pre-made food available from the nurses that you can access after hours, if necessary.  Bringing a snack for yourself probably isn't a bad idea, but it's certainly not a necessity.
• Blankets:  Someone will always bring you a blanket if you or your baby are cold.  That said, it doesn't hurt to dress both yourself and your baby in layers so that you can shed/add clothing as conditions dictate.

What is your experience with hospitalizations?  What would you add to the list or delete?

Yet Another Trip to the Hospital

Yes, you read that correctly.  We were in the hospital with LB.  Again.  That's twice in two weeks if you're keeping track.  No fun at all.  We are very ready for cold/flu/gastrointestinal nastiness season to be O.V.E.R!

This bug started on Thursday afternoon.  LB had been doing just fine all day.  I picked him up from the sitter.  She told me he ate well, napped well and had just finished a 4 oz bottle at 3:30.  We loaded into the car, drove 5 minutes home, unloaded from the car and were taking off jackets when Husband announces that LB just threw up in the hallway.  He has never vomited before, but he spits up a lot (just like our older son did when he was a baby...hence why all of the baby pictures of our boys have them wearing bibs...usually wet ones), so I was surprised.  Sure enough, there was LB sitting in a pool of vomit.  Gross.

Vomiting is something that's very dangerous with MCADD because the food doesn't get digested and he is essentially fasting (which is bad).  I called the sitter to double check when his last meal was before 3:30 because now we couldn't count the 3:30 feeding since it had just puddled in our hallway.  She said he ate his last bottle at 11:15, just before he ate some solid food for lunch.  It had now been a little over 5 hours since his last meal.  We were good for another 3 hours, but that meant he had to keep down his next feeding.

Thinking it may have been a fluke, we made a bottle for him and he prompty threw it up.  We waited another 30 minutes, tried again and he threw that up so we called the metabolic clinic.  They told us to start his polycose solution.  He needed to eat 0.5 ounces of polycose every 15 minutes for the next hour in order to stay in the clear and we needed to call them back in an hour to let them know how he was doing.

In the next hour, he drank a whopping total of 0.25 ounces of polycose and threw up 3 more times.  We were already packing our hospital bag when we called the metabolic clinic back.  It was about 7 pm when we got everyone into the car.  We left a key with the neighbors to let the dog out in the morning and we changed our older son into his jammies and dropped him off for a sleepover night with his sitter (at his choice -- we asked him if he wanted her to come over to sit with him for awhile or if he wanted to go sleep at her house and he wanted to go there).  This ended up working out nicely because this meant Husband could stay the night with us and since our plan was to go directly to Children's Hospital to avoid another IV incident like we had at the other, closer hospital, it was going to be about twice as far for Husband to run back and forth from the hospital to home.


When we got to the hospital, I was a little worried because there was a waiting room FULL of sick kids waiting to be seen.  Thankfully, as we were getting checked in with the desk, they already had LB's file ready and the metabolic clinic had already called ahead to let them know we were on our way.  After getting checked in and giving them our emergency letter, we sat in the waiting room for less than 5 minutes before we were called back.  This was good because it was already after 8 pm and it was rapidly approaching 8 hours since LB's last feeding (and he can only go 8 hours without eating when he's well anyway). 

We were seen by the doctor quickly and the IV situation was much improved at this hospital.  The nurses were able to draw bloodwork with the first poke (his inner elbow), but weren't able to advance the catheter to start the IV at that site.  They poked him a second time (left hand) and the IV was flowing.  Not bad.  Now, LB just had to keep up his end of the deal -- stop vomiting and start eating. 

Unfortunately, the second part proved a bit more difficult.  He was still vomiting in the ER and he wasn't very excited about drinking anything (do you blame him?).  So, within a couple hours of walking through the door, we were admitted.  It's a good thing I packed extra clothes this time because all of the vomit was landing right on me.  The vomit was all polycose (which is essentially sugar water), so as it dried, it was like I had patches of heavily starched clothing that was stiff as a board.

Overnight was a bit better.  The anti-nausea drugs they were giving him through the IV quelled the vomiting and he was eating a little bit every couple of hours.  I sat holding LB in a recliner.  Husband stretched out on a very uncomfortable couch.  The nurses woke us every couple hours, but that was a good thing.  We were both so tired, I'm sure I would have slept through any alarm I would have set.

In the morning, we were seen by a gaggle of pediatric residents (they literally have 8 people on a team since it is a teaching hospital and all 8 of them crammed into our room to chat with us) and a doctor from LB's metabolic clinic.  They all agreed that as long as he was eating 2/3 of what he normally does and didn't have anymore vomiting or start having any diarrhea, we would be going home that day.  He had likely caught another gastrointestinal illness and it would work its way though his system just like the others had done.  As long as he was eating, he would be fine.

By mid-day, LB was going about 100 mph.  He wanted to play.  He wanted to crawl (which he couldn't do on the hospital floor -- ick!).  He wanted to pull on that thing that was attached to his left hand.  Keeping him from tugging on the IV was very difficult this time because it was so accessible by being in his hand.  He was chewing on it, tugging on it, trying to use that hand even though it was splinted...  Needless to say, at about 1 p.m. I noticed his splint was sopping wet. It was too wet for it to be just from him sucking on it when we weren't looking (trust me, we were looking about 99.9% of the time), so I called in the nurses to take a look at it.  Sure enough, he had dislodged something and as they were attempting to salvage it, he was squirming around so much that they lost it.  No more IV. 

However, when the docs came back to check on us they were unconcerned about the IV.  They wanted to see him eating solely on his own at this point anyway and we were on target to get out of there by dinnertime.  We stopped at the pharmacy to fill his prescription for more anti-nausea drugs (just in case he started vomiting again) and were on our way home.

We picked up our older son first thing and he was very happy to see us and he told us about how much fun he had sleeping at his sitters house.  We had forgotten to pack his toothpaste, so he told us about how her toothpaste tasted different.  That was the extent of his "trauma" from this experience.  He was fine...until he wasnt.

Last night, he started vomiting.  LB was on the mend and now his big brother was just getting started.  Oh well, back to toast and gatorade for us again.  At least we're home.

Husband and I have been wracking our brains trying to figure out how the kids keep getting sick like this. Sure there has been a lot of talk on the news lately about flu and nora-virus outbreaks in the area, but we literally haven't left the house since Christmas.  We have been to ZERO public places...except for church.  We went to church the Sunday before each illness started.  As much as it pains me to say it, in the interest of keeping ourselves AWAY from the hospital for the rest of this unprecendented season of viruses, we are going to start avoiding all crowds for the foreseeable future, including church.  Two hospitalizations in two weeks and three in the last three months is plenty.  I have no plans of adding to that total anytime soon.

Second Hospitalization - A little scary

LB caught another stomach bug.  He had a couple messy diapers for both us and the sitter on Tuesday, but he was happy and eating just fine (26 ounces of formula, plus three meals of solid food and a nice bedtime snack).  As I was rocking him back to sleep very early on Wednesday morning, he had a diaper blowout that required both of us to change our clothes, so we kept him home on Wednesday to keep an eye on him. Once again, he was his usual happy self and eating just fine (28.5 ounces of formula, plus three meals of solid food and a nice bedtime snack). 

Thursday morning, he had three messy diapers before breakfast so he once again stayed home with me.  Although he was still happy and eating just fine, he was getting a little bit upset about the nasty diaper rash he was developing. I was getting a bit concerned about the volume of diarrhea he was having because it was to the point that I could barely throw the diaper outside in the trash and get my hands washed before we were changing another one.  By the afternoon, I called his specialists at the metabolic clinic to see what we should do.  The last time this happened, he had messy diapers, but he was also not eating. He was eating just fine this time, so I wasn't quite sure what to do.

After hearing our saga, the doctor immediately said that LB was too young to be losing that much fluid.  She wanted him to have lab work done immediately to check his levels and the only place we could go at that time of day (5 p.m.) was to the emergency room.  She asked where we were going so she could call ahead and warn them that we were coming.  I packed the diaper bag with lots of formula, wipes, bottles and our special can of polycose (sugar solution) and our prescription of carnitine that has been waiting in our cupboard for use when little brother is sick and headed for the ER.

When we arrived, they were waiting for us and we were ushered back into a room quickly.  The pediatrician who saw us had already talked to the metabolic specialist and had ordered his needed labs and IV fluids.  She said she was surprised that LB looked so good.  She had expected him to be lethargic and dehydrated, but here he was laughing at her, drooling and trying his darndest to wiggle out of my arms so that he could explore our new surroundings.  Things seemed to be going well, although she warned us that we likely wouldn't be going home right away since the metabolic doctor had advised her that we should be admitted for observation and fluids.

Things started to get worse when they came to start his IV.  It was a team of two nurses.  One nurse tried the inside of his left elbow with no luck.  The other one tried the inside of the right elbow, again with no luck.  Then, the first nurse said she would go get another nurse.  The third nurse I recognized as the one who was able to get his IV in on the first try the last time we were in the ER, so I felt confident that this would be accomplished quickly.  I was wrong.  She tried his left elbow and his left hand with no luck either.  We were up to five pokes and there was a bag of IV fluid that he needed sitting right there on the counter.  I was beyond frustrated that they couldn't find a single vein.

A little time passed and Husband arrived to be my emotional support since our older son was now asleep with the neighbor watching him.  They called down two nurses from the floor, one from the PICU and one from the NICU.  They tried to get veins in his ankles on each foot without success either.  We were told that babies this age were hard in the first place because of the layer of baby fat they have.  LB was extra hard because he was dehydrated and that made it even more difficult to find a vein.  We were now at seven pokes.  Still no IV.

Fortunately, he was still drinking just fine, so the pediatrician in the ER called the metabolic physician and asked if we could attempt to have him maintain on his own orally.  She agreed and gave us instructions for mixing his polycose and carnitine with pedialyte.  He needed to drink a minimum of 2 ounces every hour and that he did.  Once the 8 tablespoons of polycose was added to four ounces of pedialyte, we had 5 ounces of liquid that he happily downed every time a bottle of it was presented to him.  I'm sure it was like drinking a pixie stick.  I was worried that he would never drink formula again by comparison.  We were admitted to the pediatric unit shortly after midnight and I spent the night sleeping on the hospital couch with LB and waking every 2 hours to feed him his sugar solution.

By the morning, his diarrhea still had not subsided and his labs looked bad.  Really bad.  The physician on the floor said that even if she didn't know he had MCADD, his labs indicated that he needed IV fluids.  He was losing more fluid than he was taking in and at the rate of loss (3 diaper explosions per hour at a minimum), there was no way he could make up that ground just by drinking.  Even an adult couldn't do it.  They needed to get an IV in.  So, they called in some more nurses from the PICU, each of whom poked him once and neither of them got the IV in either.  We were up to nine pokes now and I was practically hysterical.  I couldn't stand to see anyone else dig around under his skin for  vein while he wailed in pain.  I knew he needed the IV.  I knew they were just trying to help him, but it was still so hard to watch.  I hated seeing him hurting. 

The doctor said it was time to start thinking about plan b -- possibly a central line or possibly a pic line -- because he needed those fluids badly and the longer we waited, the worse it was going to get.  Now, I was really scared.  It was hard enough to watch the IV attempts.  Now, they were talking about sedating him and taking him to the OR?  And the scariest part was that no one was telling me reassuring things like "he'll be ok" or "he's still doing fine."  The conversations with the nurses and the doctors all said one thing -- "he needs IV fluids fast" -- yet no one seemed to be able to help him.

At this point, LB was exhausted and had fallen asleep in my arms.  The doctor said to let him rest for a bit.  They would try one more time for a peripheral vein with their very best person and that they would do everything they could to stack the deck in his favor (warming his hands and feet with warming pads, taking him to the procedure room on the floor where the light was best, looking at all the options for veins before taking the very best option).  If it didn't work this time, we were going to get serious and head to the OR.

The entire time LB was napping in my arms, I was praying.  I was sobbing and I was praying.  I called/texted/facebooked everyone could think of and asked them to pray for LB.  I needed some divine intervention in the form of someone who could get an IV in him.  I didn't want to see him go through a procedure like a central line.  I needed to see that bag of IV fluids that had traveled with us from the ER to the floor doing him some good.  I needed to know that he was going to be ok.

Shortly after noon, his nurse came in and said it was time.  I took a deep breath and carried him down the hall to the procedure room where we met Heidi, the nurse from the NICU who was our last hope.  She looked closely at all the options she had to place the IV before deciding on his left foot.  I laid him down on the table and held him securely while singing a song softly into his ear.  I couldn't watch again.  He cried and I sang to him.  After a while, I heard Heidi ask if she should draw the labs, too.  I looked up and asked if the IV was in.  Heidi smiled and said she had gotten it on the first try.  I was so happy that I started weeping.  He was finally going to be ok.  He was finally going to get the fluids that he needed.  Our prayers had been answered. 

We returned to our room and set about letting the IV fluids work their magic.  They wanted at least 12 hours of fluids, so we would need to spend another night in the hospital.  They also wanted to give his intestines a break, so they switched him to a special lactose-free formula.  They said I could feed him as often as he was hungry, but only 2 ounces at a time and to try and space the feedings at least 30 minutes apart so we weren't overwhelming his system with large quantities of liquid that would inevitably just go right through him. 

It was hard to keep him happy with only 2 ounces at a time, especially because I was also preventing him from practically all physical activity to protect that IV site from any damage.  I had a stir-crazy baby who hadn't been allowed to crawl, cruise or walk since Thursday afternoon or inspect the contraption wrapped around his left foot, despite the fact that he was being fed pure sugar for 24 hours before being switched to intravenous sugar that afternoon.  Let me just say, it was an interesting stretch of time.  Thankfully, Husband brought us a nice assortment of books and toys and the floor had a highchair that they had brought to our room.  It ended up being a rotation of me singing songs to him while holding/bouncing him around the room, followed by a stretch of sitting in my lap reading books, followed by sitting in the highchair playing with toys, followed by a bottle and sometimes a nap.  We did whatever kept him happy and prevented him from pulling at his IV and it worked.

By Saturday morning, his diarrhea had subsided and his labs were looking much better.  His sugar numbers were normal.  His acid numbers were normal.  His salt numbers were high though so they disconnected the IV since he was probably getting too much salt through the combination of IV and liquid intake by mouth.  We were told that they would repeat the labs that evening and probably send us home if he continued to feed well, continued to have normal stools and had good lab results at the end of the day.  We counted the minutes until the labs were drawn and were ecstatic when the results came back normal.  We were going home!  Three days before Christmas, we were headed home!

That night, as Husband and I tucked our boys, safe and warm, into their very own beds, under our roof, we were profoundly grateful.  While LB and I were in the hospital, our older son was home with Husband suffering from a similar stomach bug.  In all, the last few days in our lives were not pretty -- hospitals, a crying baby getting poked for IVs and blood work, dirty diapers, vomit, you name it -- but even if we only ate toast on Christmas and even if no one in the house felt well enough to change out of their pajamas, it was going to be just fine because we were going to all be home together.  I didn't need anything else for Christmas, just the ability to be home with my boys.  My Christmas wish had already come true.

Our First Hospitalization

We have had a bit of a rough week...

LB has been cutting his first teeth. This has made him fussy and cranky, especially at night. He has also had some seriously messy diapers (a teething side effect that I remember from our older son, too). It also started to affect his food intake, which with his MCADD is very bad. We were on the verge of calling his specialists at Children's Hospital on Friday night because his intake was down about a third from where it normally is, plus those awful messy diapers. Thankfully, at 2 a.m. when we were contemplating the call, he magically sucked down a full bottle and we thought things were getting better.

On Saturday, his second tooth appeared and he seemed happier. He was having hourly diaper blowouts, but was eating just fine (slightly less than normal, but nowhere near a third less than normal where we start getting concerned) and playing happily. Then, by the end of the day, he was very mad. The diaper issues had caused some pretty angry diaper rash and his tummy was very hard. I could tell he was uncomfortable, so we called the pediatrician who suggested we switch him to the "gentle" version of his formula to help with the gassiness and do some baking soda baths along with a seriously thick coating of diaper rash cream to make him more comfotrable. A quick run to the store before bedtime for the necessary supplies and we were on our way to feeling good again.

On Sunday, the rash was much improved, the diaper messiness had subsided considerably (2 blow outs for the entire day instead of 8!), and his food intake was up a couple ounces from the day before. We definitely thought we were out of the woods.

On Monday, we took the boys to the sitter, but picked them up an hour and a half early so we could take them to the flu shot clinic at the pediatrician's office. Usually when I pick up the boys, their sitter proudly tells me that LB ate 12 ounces and had a great day (she considers it her personal mission to feed the child at least 12 ounces regardless if he's hungry of not...did I mention she is a grandmother? =). Our regular sitter was actually out of town, so her friend was substituting for her for the day. When she came to the door, she looked worried and LB looked terrible -- he had red circles around his eyes and wasn't as happy and smiley as he normally is when I pick him up. She said he didn't have a great day, kept turning away from the bottle on her and had been having messy diapers again. She said he had only eaten 5.5 ounces while he was there.

It was as if someone sucked the air out of my lungs. I rationalized that it was probably just because she was an unfamiliar face and he didn't want to take the bottle from her (even though she is a Grandma of 15 and has plenty of experience with babies!). I made a bottle for him in the car and as soon as we got to the pediatrician, he ate all 4 ounces for me. Both boys got their flu vaccinations and as we were leaving, I asked if our pediatrician was in the office today. The receptionist said he wasn't so I just left it at that. He had eaten, so he was probably ok.

On the way home, I started adding up all the messy diapers, the decreased formula intake and the telling red circles around LB's eyes. My gut told me we needed to call his specialists, just to be sure he didn't need to start on his special sugar-solution formula for a little boost while he was getting over this teething thing (or was it a stomach bug now? how could you tell?).  Husband agreed with me, so we called them as soon as we got home.

We reached our genetic counselor first, told her what was happening and she said she would talk to the doctor and get right back to us with a plan for what we should do. The phone rang not five minutes later. She said the doctor was concerned and that we should go to the ER. LB was probably getting dehydrated from all the diarrhea and the decreased food intake wasn't helping. She said he would probably just need to be on some IV fluids for a few hours and they might be able to send us home again.

I gathered a supply of diapers and formula, called a friend to stay with the little man and headed for the ER. Our friend couldn't get to the house right away, so Husband could meet me at the ER after she arrived to play with our older son for the evening. The ER experience wasn't the best, but wasn't the worst either. Our emergency letter that was supposed to get us to the front of the line and into a room with an IV running as quickly as possible didn't quite work out as expected. The guy at the desk and the triage nurse both refused to look at it, instead telling me to show it to the doctor once we were in our room. We were sitting in a curtained room within about 20 minutes (which isn't too bad) and saw the doctor almost immediately thereafter. She looked at LB, read his letter and ordered his special dextrose IV fluid (liquid sugar) along with some lab work. The doctor told me he was slightly dehydrated and that after running fluid for a few hours, he'd probably be able to go home. The unfortunate thing was that the IV fluid didn't arrive until TWO HOURS after we had arrived at the ER. It was a good thing he was only slightly dehydrated. Things could have gotten really dangerous if he was really in metabolic crisis and his IV was slightly delayed by two hours!

LB was a real trooper in the ER. He snuggled with me and took a couple nice naps. He was slightly annoyed by the IV because they had to put it in the crook of his arm (the best vein they could find) and placing it there meant that they needed to strap his arm to a little board to keep it straight. His overwhelming desire to suck on that particular hand got the best of him from time to time and he would get mad, but I was usually able to quickly distract him with a toy or a lullaby. All of his labs came back within normal range, so the ER doc assured us that this treatment would really give him the boost he needed to get well.

Things were going fine and after a couple hours of IV fluids, he was already looking much more alert, with the circles around his eyes disappearing, BUT he still wasn't very interested in eating and then he had this wildly impressive diaper explosion (that we were happy to have happen in the ER instead of in our house where we would have had to clean it up). At that point, they said they were admitting us for the night.

We got to our room around 10:30 p.m. Most of the other kids on the floor must have already been sleeping for the night because the nurses were focused exclusively on us for the next couple hours. I filled out a bunch more paperwork, they set us up with a stockpile of diapers, wipes, blankets, formula and toys. They also asked me if I was hungry, which I was (I had the foresight to pack a PB&J, but had been at the hospital since 4:00 p.m. with only that sandwich to eat since lunchtime), so they brought me a deli sandwich, some fruit and a bag of potato chips which I happily gobbled up.

We slept curled up on the pullout couch since LB wasn't happy in the hospital crib and by sleeping on the couch with me, I could help keep his arm straight so that the IV could continue to flow unobstructed (he could bend his arm slightly even with the arm board, so everytime he did, his IV would stop flowing and start beeping). It was a restless night of sleep for me, but LB slept rather peacefully despite all the nursing checks every half hour or so. He woke up bright eyed and bushy tailed at around 5:30 a.m. and he was literally a brand new kid -- alert, happy, playing, drooling, flirting with the nurses. It was amazing to see the difference from the night before.

Once he was awake, the IV beeping became incessant as he kept trying to use his arm so the nurses made the executive decision to disconnect it. The doctor came in to see us and said that his morning labwork had shown improvements from the night before (he referred to his numbers as "stone cold normal" now) and as long as he ate well and didn't have any more diaper explosions, we could go home after lunch. We stuck to that plan, LB happily drank his bottles as well as munching some cheerios and applesauce (photo below) and sure enough, were headed home around 1 p.m. -- hooray!

I took a little nap that afternoon while Husband watched LB. By the time it was time to go pick up his big brother from the sitter, I felt like our life was pretty much back to normal.

LB was acting fine again on Wednesday, but I didn't want to send him back to the sitter quite yet -- I needed to keep him in my sight until I was absolutely sure he was ok. It was a good thing I did because the messy diapers returned after his morning nap, so we followed up with a visit to the pediatrician who told us that the stomach bug that is going around typically lasts for 10-14 days. The dirty diapers would last a little while longer, but as long as his food intake stayed up, his labs from the hospital indicated that he was getting enough nutrients from his formula (before it was violently expelled from the other end) that he would likely not have to go back to the hospital. His advice was good and the diapers gradually returned to normal over the next couple days. His food intake continued to gain ground until we were back to normal by the weekend. What a relief!

So, our first hospitalization turned out fine. I sure would rather have not had to take him there, but the blessing of his diagnosis is that we know that we have to catch things like this early and act aggressively to prevent him from getting sicker. That's exactly what we did and he bounced back extraordinarily quickly. Honestly, the whole experience was probably harder on his Mommy than it was on him!